• Sr Specialist | PI - Quality & Safety…

    Sharp HealthCare (San Diego, CA)
    …be utilized for ongoing professional practice evaluation and re-credentialing.Collaborates with physician leadership to establish meaningful peer review criteria ... **What You Will Do** The purpose of the Sr. Performance Improvement Specialist is to improve clinical outcomes including responsibilities relating to leading teams… more
    Sharp HealthCare (12/14/25)
    - Related Jobs
  • Patient Therapy Access Specialist

    Abbott (Plano, TX)
    …insurance, Worker's Compensation and Medicare guidelines pertaining to Prospective and Retrospective Utilization Review . Some experience in medical device or DME ... currently has an opportunity for a **Patient Therapy Access Specialist ** (PTA). This is an in office 5 days...Compensation and Medicare guidelines pertaining to Prospective and Retrospective Utilization Review . + Experience in medical device… more
    Abbott (11/18/25)
    - Related Jobs
  • Assessment Specialist PRN

    HCA Healthcare (Nashville, TN)
    …treatment is reimbursed by contacting managed care organizations and completing initial utilization review . Documents in Midas as required. Involves mobile ... on face to face or telemedicine assessment completed and physician consult. + Provides a thorough clinical review...patients in regard to managed care organizations + Conducts utilization review for managed care cases in… more
    HCA Healthcare (11/10/25)
    - Related Jobs
  • Healthcare Clinical Documentation…

    Deloitte (Los Angeles, CA)
    …nurse, physician , physician assistant, case manager, clinical documentation specialist , utilization review , informatics RN, Quality, DRG Validation ... Healthcare Clinical Documentation Specialist - Senior Consultant Our Deloitte Regulatory, Risk...for physicians, CDI team and ancillary staff and assist physician champion to conduct education as needed + Train… more
    Deloitte (11/21/25)
    - Related Jobs
  • Authorization Specialist

    WMCHealth (Port Jervis, NY)
    …checks. . Obtain, validate and interpret clinical documentation including orders, H&P, physician progress notes, review lab results, radiology results, assuring ... Authorization Specialist Company: Bon Secours Community Hospital City/State: Port...financial responsibility, insurance or authorization issues ensuring a positive patient/ physician experience through transparency. . Performs eligibility checks on… more
    WMCHealth (12/16/25)
    - Related Jobs
  • Clinical Documentation Improvement…

    University of Southern California (Arcadia, CA)
    …Minimum of three years' experience in clinical disciplines (RN, MD, FMG) or utilization review /case management in an acute care facility, with clinical ... and other clinical staff. + Meets established productivity targets for record review and appropriate query placement. + Demonstrates working knowledge of ICD-10 CM… more
    University of Southern California (11/24/25)
    - Related Jobs
  • Principal Physician (40 Hour)

    State of Connecticut, Department of Administrative Services (Hartford, CT)
    …+ Prepares and/or reviews reports, medical records and correspondence; + Perform utilization review and management functions; + Attends court hearings as ... Principal Physician (40 Hour) Office/On-Site Recruitment # 251217-4661RQ-001 Location...training are most aligned with the role. To prepare, review this helpful Interview Preparation Guide to make the… more
    State of Connecticut, Department of Administrative Services (12/24/25)
    - Related Jobs
  • Primary Care Provider ( Physician Assistant…

    STG International (Yellowstone National Park, WY)
    …safety. * Participate in quality improvement, care management, risk management, peer review , utilization review , clinical outcomes, and health enhancement ... STGI is currently seeking a Primary Care Provider ( Physician Assistant or Nurse Practitioner) to join our...Performance Improvement Team (QPIT) strategic initiatives. * Participate in review and improvement of clinical success in areas of… more
    STG International (10/31/25)
    - Related Jobs
  • Clinical Denials Prevention & Appeals…

    Nuvance Health (Danbury, CT)
    …(PA) for a second level review . * Forward cases that require secondary physician review to appropriate resource (eg, Physician Advisor). * Resolve any ... of review . If unable to resolve, escalate to the PA and Utilization Review (UR) Leadership. * Coordinate with the care team in changing patient status, as… more
    Nuvance Health (12/25/25)
    - Related Jobs
  • Clinical Rehab Specialist PRN

    HCA Healthcare (Tallahassee, FL)
    …is important to you, we encourage you to apply for our Clinical Rehab Specialist PRN opening. Our team will promptly review your application. Highly qualified ... support our colleagues in their positions. Join our Team as a(an) Clinical Rehab Specialist PRN and access programs to assist with every stage of your career.… more
    HCA Healthcare (11/10/25)
    - Related Jobs